Individual
RICKY NOLASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2465 HOLLYBROOK WAY, MANTECA, CA 95336-8337
(209) 647-9701
Mailing address
2465 HOLLYBROOK WAY, MANTECA, CA 95336-8337
(209) 647-9701
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT9663
CA
Other
Enumeration date
10/14/2014
Last updated
10/14/2014
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